经皮球囊二尖瓣扩张术并发症的外科治疗

本院自１９８７年１０月至１９９５年９月，３５０例行经皮球囊二尖瓣成形术后发生并发症需要外科治疗的８例患者，其中心脏穿破致急性心包填塞３例、脑栓塞１例、创伤性重度二尖瓣关闭不全２例、创伤性房间隔缺损５例。外科采用紧急开胸止血、左心房血栓清除、修补创伤性房间隔缺损、二尖瓣置换、左径二尖瓣扩张术等治疗方法。作者认为：经皮球囊二尖瓣成形术后发生并发症，应及时采用适当的外科治疗措施，切勿延误治疗时机；经皮球囊二尖瓣成形术需有一定的适应证，不能完全替代二尖瓣置换术或直视二尖瓣成形术。

surgical treatment of complications after percutaneous balloon mitral valvuloplasty

Eight patients (8/350) underwent percutaneous balloon mitral valvuloplasty (PBMV) had complications with surgical treatment was reported. The complications included acute pericardial tamponade due to heart injury (3/8), cerebral embolism (1/8), traumatic mitral regurgitation (2/8), and traumatic atrial septal defect (5/8). We suggest: (1)Surgical team must stand by for emergency during PBMV procedure. (2)The patient should be followed up closely even if the PBMV has been successfully done. If the effect is undesirable or any complication exists, operative intervention should be considered as early as possible. (3) PBMV has its own indications and contraindications. PBMV can not replace mitral valvuloplasty or mitral valve replacement entirely.